 
                Get Wi Dqa F-60945 2013-2025
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How to fill out the WI DQA F-60945 online
Filling out the WI DQA F-60945 form is a crucial step in the process of applying for an adult family home initial license in Wisconsin. This guide provides clear and supportive step-by-step instructions to assist you in completing the form accurately and efficiently online.
Follow the steps to complete the application successfully.
- Click ‘Get Form’ button to obtain the form and open it in the online editor.
- Read the important notes provided at the top of the form regarding the completion and submission requirements, including the necessity of attachments.
- In the facility information section, input the name, Federal Employer Identification Number (FEIN), address, contact numbers, and email address for the facility.
- Complete the facility administrator information by providing the administrator's name, birth date, mailing address, contact numbers, and email.
- Designate a mail recipient by filling in their name, contact number, mailing address, and email.
- Provide resident information, including total resident capacity and client group(s) you intend to serve. Check the applicable boxes.
- Complete the licensee information section, indicating the type of ownership and providing relevant details about the owner or president.
- Respond to the fit and qualified section with accurate information regarding previous licenses or certifications.
- Input the monthly fees for resident care, including both minimum and maximum charges.
- Enter your monthly operating expenses and sources of funding, ensuring that financial stability documentation is included.
- List any non-resident information by providing names and relevant details of persons aged 10 and older living in the facility.
- Fill in the fire department information, including the department's name and contact details, and provide directions to the facility.
- Review all entered information for accuracy, sign and date the application, confirming the truthfulness of the information provided.
- Once completed, you can save changes, download, print, or share the form as necessary.
Complete your WI DQA F-60945 form online today to ensure a smooth licensure process.
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No, assisted living facilities in Wisconsin are primarily regulated at the state level by the Department of Health Services. The federal government does set some guidelines surrounding Medicaid services, but WI DQA F-60945 is specifically a state regulation. This state oversight helps cater to the unique needs of residents in Wisconsin. Staying informed about these regulations can help you navigate the system more effectively.
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